Charles Gaba's blog

I've confirmed with the Massachusetts Health Connector that their official QHP selection tally stood at exactly 262,534 as of Christmas Day (12/25).

This puts them a mere 232 higher than they were 6 days earlier (12/19), which seemed a little odd to me given that 12/23 was MA's deadline for January 1st coverage; normally I'd expect a last-minute enrollment surge in the final days ahead of a big deadline, although it's not nearly as big a deal in the states which still have later deadlines for February or March coverage. On the other hand, Christmas Eve and Day were included here, and no one enrolls in health insurance on Christmas, of course. I wouldn't expect much this week either with New Year's coming up; there's usualy a 9-day Dead Zone from 12/24 - 1/01 anyway.

Breaking News from Your Health Idaho:

Despite Changes, Idahoans Flock to Health Insurance Exchange
2018 Enrollment Nears Record

BOISE, Idaho – Your Health Idaho announced today that nearly 102,000 Idahoans signed up for 2018 health insurance coverage on the exchange.

“This is a testament to Idaho’s model for operating an exchange. Despite the enormous uncertainty from Washington, combined with a shortened enrollment period, Your Health Idaho has been able to serve near record numbers of Idahoans,” said Pat Kelly, executive director of Your Health Idaho.

The enrollment numbers include new and returning customers. A significant difference for 2018 is the monthly premium pricing. Increased tax credits offset rising premiums to the extent that some Idahoans purchased plans for little to no monthly cost. Enrollments in these less expensive bronze plans increased by fifteen percentage points over the previous year. In total, 101,793 Idahoans enrolled in 2018 health coverage in just half the time of last year.

via the Providence Journal:

HealthSource RI enrollment far exceeds projections

Updated Dec 22, 2017 at 7:48 PM

More than 30,700 have already signed up, and hours at the walk-in and call centers have been extended in anticipation of a surge in enrollments leading up to the Dec. 31 deadline.

PROVIDENCE — Rhode Island has outpaced projected sign-ups for Obamacare next year with more than 30,700 residents now enrolled in health insurance through the state-based health insurance exchange.

HealthSource RI officials expected to see around 30,000 people in total enrolled by the end of December. With a little more than a week to go and the last days of open enrollment typically the busiest, numbers are sure to increase.

I know it's Christmas Eve, and I know it's not the biggest deal in the world, but this headline has been irritating the hell out of me for the past couple of days:

More than 4 in 5 enrolled in Obamacare are in Trump states

WASHINGTON — Americans in states that Donald Trump carried in his march to the White House account for more than 4 in 5 of those signed up for coverage under the health care law the president still wants to take down.

An Associated Press analysis of new figures from the government found that 7.3 million of the 8.8 million consumers signed up so far for next year come from states Trump won in the 2016 presidential election. The four states with the highest number of sign-ups — Florida, Texas, North Carolina and Georgia, accounting for nearly 3.9 million customers — were all Trump states.

Yes, this is true: ~7.3 million out of 8.8 million, or roughly 83%, of enrollees in the 39 states covered by HealthCare.Gov do indeed reside in states won by Donald Trump last year.

This may be a little anticlimactic, but AccessHealthCT has added another 7,600 enrollees in the past 5 days and still has two days to go...

Connecticut's Health Insurance Open Enrollment In Its Last Hours

Open enrollment on the state’s health care exchange, Access Health Connecticut, ends Friday at midnight. 

Connecticut residents had one week longer to sign up for an insurance plan than customers of the federal site, healthcare.gov.

As of Thursday morning, some 106,000 people had signed up for health care plans through Access Health CT.

Exchange CEO Jim Wadleigh called this the most challenging open enrollment period in the five years it’s been up and running, citing uncertainty over the future of the health care law, mixed messages from the Trump administration, and the shortest enrollment period ever, at just seven weeks. 

Just yesterday MNsure issued an unofficial tally of 106,000 QHP selections through 12/19. Yesterday also happened to be their December deadline for coverage starting in January, although their Open Enrollment Period still runs through January 14th.

Today they updated the number officially, including the final mid-season deadline:

Private health coverage enrollments through MNsure top 108,500 following first deadline

Total enrollments for 2018 now 12.5 percent ahead of where they were this time last year

ST. PAUL, Minn.—Following the first deadline for 2018 coverage, 108,540 Minnesotans have enrolled in private health coverage through MNsure. Yesterday, December 20, was the deadline for coverage beginning January 1. Minnesotans have until January 14 to sign up for coverage starting February 1, 2018.

Last year after the first deadline, MNsure had 96,540 enrollments, putting this year 12,000 enrollments ahead of last year at this time, or 12.5 percent.

Now that it appears that the full list of states and counties eligible for hurricane (or windstorm, in the case of Maine) Special Enrollment Periods (SEP) has settled down, Huffington Post reporter Jonathan Cohn asked an interesting question:

How if at all do you allow for the extensions in FL, TX, etc.? Or, to put another way, how many post-Dec 15 signups through https://t.co/bhGNSognZK do you expect?

— Jonathan Cohn (@CitizenCohn) December 20, 2017

The closest parallel to this particular situation I can think of was the #ACATaxTime SEP back in spring 2015. In that case, it was the first year that the ACA's (defunct as of this morning) Individual Mandate was being enforced, and a lot of people either never got the message about being required to #GetCovered or at least pretended that they didn't.

This is a pretty minor update to my last Massachusetts post, but every enrollment counts: I've just received confirmation from the MA Health Connector that the Bay State has tallied up 262,302 plans selected or enrollments as of 12/19.

Their record to date was last year, when they had a total of 266,664 QHP selections through January 31st, 2017...and unlike most states, the deadline in MA is still a month away (residents have until 12/23 to enroll for January coverage and until 1/23/18 to enroll for February coverage).

This gives Massachusetts a full 5 weeks to add at least 4,400 more people to break that record. They've added 2,487 in the past 13 days; if they kept that pace they'd add 6,685 more between now and 1/23, so it's not unreasonable to think they can pull that off.

UPDATE: OK, it looks like the big HealthCare.Gov Final Surge Report is gonna be released sometime Thursday morning. Unfortunately, I have a can't-miss meeting in the morning as well, so there's a good chance that after sitting at my desk and constantly refreshing/checking email all day today, I may ironically end up missing the big reveal and not being able to post about it for an hour or so after it comes out.

UPDATE 12/21/17: As of 2:00pm, still nothing. Speculation now brewing that they may be hoping to bury the report at 4:59pm on the Friday before Christmas. Hoping to be proven wrong.

UPDATE 2:35pm: h/t to Adam Sacarny for the head's up:

Exchange open enrollment for 2018 coverage ended w/ approx 8.8M people enrolling in coverage. Great job to the @CMSGov team for the work you did to make this the smoothest experience for consumers to date. We take pride in providing great customer service.

Not an official enrollment update report but close enough (via email from MNsure):

December 20, 2017

Today is the last day for Minnesotans to sign up for health coverage beginning January 1

ST. PAUL, Minn.—Today is the last day for Minnesotans to sign up for health coverage beginning January 1, 2018. Over the last few days, and including the start of today, MNsure has been very busy. Yesterday, there were over 50,000 MNsure.org sessions and MNsure fielded over 5,000 calls. Today is off to a strong start as well, with nearly 21,000 MNsure.org sessions and over 2,200 calls.

To date, MNsure has enrolled over 106,000 Minnesotans in health coverage for 2018 and the average tax credit for Minnesota families is over $7,000 a year.

MNsure.org will remain available for consumers to shop until midnight and the contact center will remain open till midnight as well. Any calls on hold at midnight will be answered.

If Minnesotans do not apply for health coverage by midnight tonight, they can still get coverage beginning February 1, 2018 if they apply by January 14, 2018.

BUSY DAY: I was expecting the big Week 7 HC.gov Snapshot Report to come out this morning, but it hasn't been released yet. Instead, I have major updates from the three largest state-based exchanges: New York, California and now Washington State...and of the three, WA is the most impressive:

Washington Healthplanfinder Sign-Ups Jump Past 230,000, Shatter Last Year’s Record Pace

Final deadline for remaining customers to select 2018 health and dental coverage is Jan. 15

The Washington Health Benefit Exchange today announced that more than 230,000 customers selected health plans through Washington Healthplanfinder by the Dec. 15 deadline for coverage that begins on Jan. 1. Customers who have not yet applied for coverage still have until Jan. 15 to sign up for health and dental plans that begin on Feb. 1.

Covered California just announced their latest 2018 Open Enrollment Period numbers:

  • 220,000 new enrollees as of 12/15 (10% higher than last year)
  • Extended Jan. start deadline to 12/22 to handle high demand
  • Final deadline still same as last year (1/31/18)
  • ~1.2 million active or passive renewals
  • ~1.4 million total enrollees (renewals + new enrollments)

Assuming the 1.2 million figure is very close to the exact number, that makes the total number around 1.42 million QHP selections.

This brings CoveredCA within 9% of last year's total, and within 10% of their all-time total set a year earlier.

The official total as of 12/17 last year (with an extra 2 days) was 1,437,150 enrollments, about 1% higher. Given that CoveredCA is keeping to the same January 31st deadline as prior years, I'm pretty sure they'll end up very close to last year's final total when the dust settles.

UPDATE: Here's the full press release with a bunch of other info:

Covered California Looks Ahead to 2019 With Continued Strong Enrollment but National Uncertainty

THIS JUST IN via Dan Goldberg of Politico NY...

.@charles_gaba New NY numbers As of Dec. 15

2.9 million people in Medicaid
229,000 in qhp
364,000 enrolled in Child Health Plus
716,000 in Essential Plan

— Dan Goldberg (@DanCGoldberg) December 20, 2017

For context, as of 12/17/16, New York had enrolled 213,248 people in Qualified Health Plans (QHPs), putting them over 7% ahead of the same point last year...and unlike most states, New York's Open Enrollment Period is just as long as prior years, running all the way out to January 31st.

Put another way: New York's final enrollment tally last year was 242,880, meaning they're just 6% away from breaking that number with six weeks left to go. Their all-time record was set in OE2 with 409,000 QHP selections, but that's a meaningless comparison since the Essential Plan was added the following year, cannibalizing several hundred thousand enrollees anyway.

Welp. The Republicans did it. And later today, barring some dramatic last-minute development, the GOP Tax Scam is gonna be signed into law.

UPDATE: It's done. It passed the GOP House, GOP Senate and GOP House (again). Trump's signing it at any moment.

The GOP Tax Scam does many terrible things, of course, many of which are worse than repealing the ACA’s individual mandate. And even within the healthcare arena, the $25 billion PAYGO Medicare cut caused by the GOP tax scam is arguably more damaging overall.

Still, ACA stuff is my wheelhouse, so I’ll stick to the direct impact the bill (if it does become law) would have on the Affordable Care Act.

Above is the video explainer I whipped up a few weeks ago. It’s long and a bit wonky, but it should give a pretty good overview of the situation.

What about the two “market stabilization” bills that Susan Collins was supposedly demanding in return for her “Yes” vote? Yeah, about those:

Oh for heaven's sake:

Mainers could get extended health care enrollment deadline due to devastating windstorm

In the wake of a windstorm that knocked out power to more than 400,000 Mainers, federal officials have agreed to give Mainers more time to enroll for health care under the Affordable Care Act.

U.S. Sen. Angus King sent a letter to the Centers for Medicare and Medicaid Services in November requesting an extended deadline for Mainers who spent the better part of a week in the dark without internet or computer access. On Friday, King shared the agency’s reply, which said Mainers likely would qualify for a special enrollment period, extending their enrollment deadline.

“CMS recognizes that certain exceptional circumstances, including a natural disaster such as a severe windstorm, can prevent an individual from enrolling in coverage before an open enrollment period expires,” CMS Administrator Seema Verma said in her reply to King.

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